POS1164 COMPARISON OF PATIENTS WITH EARLY-ONSET GOUT AND COMMON GOUT: A CLAIMS-BASED ANALYSIS
Authors: A. Amatucci, L. Padnick-Silver, B. Lamoreaux, D. Bulbin
Journal: Annals of the Rheumatic Diseases (2022)

Background Data from the United States indicate that 8% of gout patients have disease onset before 40 years of age (early-onset gout [EOG]), 1,2 with similar age stratification in the United Kingdom, The Netherlands, and New Zealand. 3 At diagnosis, EOG patients have lower rates of renal and cardiometabolic comorbidities than their counterparts who developed gout at a later age. 4-6 Published reports also indicate that patients with EOG are less responsive to urate-lowering therapy 4 and more often have severe gout, with higher flare rate 4-6 and polyarticular disease occurrence. 4,5 At present, the literature is limited in comparisons between EOG and common gout (CG) patients. Objectives These claims-based analyses on a very large population examined and compared characteristics and comorbidity profile of patients with EOG and CG. Methods Patients with ≥1 ICD-9 or -10 gout code were identified in the Symphony claims database using Bellweather software (PearlDiver Technologies™). All patients were in the database ≥2 years before and ≥3 years after first gout code. Patients were said to have EOG if their first gout code occurred before 40 years of age. Patient demographics and comorbidities were compared to those with CG, defined here as first gout code at ≥50 years of age. Results 68,709 and 933,375 patients were classified as having EOG (mean age: 33.2±5.0 years) and CG (66.3±8.3 years), respectively. The EOG group had a higher proportion of men (72% vs. 62%). EOG and CG patients were in plan for a mean of 5.74±1.57 and 5.72±1.61 years, respectively after first gout diagnosis code. Prior to first gout code, comorbidity rates were lower in EOG than CG patients, including hypertension, cardiovascular disease, diabetes, stroke/transient ischemic attack, and renal disease. Additionally, the proportion of EOG and CG patients with hypertension, type 2 diabetes, and chronic kidney disease codes increased following the first gout code at a faster rate than in the general US population of a similar age (Figure 1). 7-9 As a result comorbidity rates were markedly higher in both EOG and CG groups in the years following gout diagnosis. Conclusion In agreement with prior studies, 4-6 these claims-based analyses suggest that patients with EOG have a lower comorbidity burden than patients with CG, though still higher than the general US population. Importantly, our data suggest that, in the years following gout diagnosis, EOG patients develop comorbidities at a faster rate than their peers without gout. Further study of how gout influences comorbidity development in EOG patients is warranted to better understand and verify these claims-based findings. References [1]Zhu Y, et al. Arthritis Rheumatol 2011;63:3136-41. [2]Chen-Xu M, et al. Arthritis Rheumatol 2019;71:991-9. [3]Kuo CF, et al. Nat Rev Rheumatol 2015;11:649-62. [4]Pascart T, et al. Arthritis Care Res 2019;71:986-92. [5]Zhang B, et al. Medicine 2016;95:e5425. [6]Li Y et al. ACR Open Rheumatol 2019;1:397-402. [7]Fryar C, et al. NCHS Data Brief 2017:1-8. [8]Mendola et al. NCHS Data Brief 2018:1-8. [9]Coresh, et al. Am J Kidney Dis 2003;41:1-12. Disclosure of Interests Anthony Amatucci Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Lissa Padnick-Silver Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Brian LaMoreaux Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, David Bulbin Speakers bureau: Abbvie, Alexion, Sanofi, Consultant of: Norvartis, Abbvie, Alexion